|Date:||29 May 2013|
|Title:||'Two dead frankfurts and a blob of sauce': The serendipity of receiving nutrition and hydration in Australian residential aged care involved in-depth interviews with family members and carers of elderly people in Australian aged care facilities.|
Dr Bernoth, Dr Elaine Dietsch and Ms Carmel Davies is published in Collegian: The Australian Journal of Nursing Practice, Scholarship and Research, 14 March 2013. Collegian is the journal of the Australian College of Nursing
Received 3 Sep 2007, accepted 29 Nov 2007
BACKGROUND: This paper explores the serendipity of residents accessing adequate food and fluids in aged care facilities. It draws on the findings of two discrete but interrelated research projects conducted in 2009 and 2011 relating to the experience of living in, or having a friend or family member living in, residential aged care.
METHODS: Participants were recruited through media outlets. Indepth interviews with participants were audiotaped, transcribed verbatim and thematically analysed.
FINDINGS: This paper discusses a theme that was iterated by participants in both projects that is, the difficulty residents in aged care facilities experienced in receiving adequate and acceptable food and fluids. Unacceptable dining room experiences, poor quality food and excessive food hygiene regulations contributed to iatrogenic malnutrition and dehydration. Implications for staffing, clinical supervision, education of carers and the impact of negative attitudes to older people are discussed.
CONCLUSION: The inability of dependent residents in aged care facilities to receive adequate nourishment and hydration impacts on their health and their rights as a resident, and is an ongoing issue in Australian residential aged care.
Supporting media release:
A picture of lonely dining experiences with poor quality and inadequate food has emerged in Charles Sturt University (CSU) research centred on nutrition and hydration in Australian residential aged care.
“‘Two dead frankfurts and a blob of sauce’: The serendipity of receiving nutrition and hydration in Australian residential aged care” involved in-depth interviews with family members and carers of elderly people in Australian aged care facilities.
“We found the communal dining room can be a lonely place where residents are left waiting for a meal which can be served at a time that suits the institution, not the residents,” lead researcher Dr Maree Bernoth from the University’s School of Nursing, Midwifery and Indigenous Health said. “Residents are encouraged to be seated in the dining room up to an hour before a meal is served.”
A prominent concern highlighted throughout the study was the quality of food served to the residents.
“The lack of culturally appropriate food and respect for the food traditions of older people; the absence of fruit to snack on; a lack of variety in the food; and an inability of the resident to actually access the food served for them were some of the issues repeatedly raised during our interviews,” Dr Bernoth said.
“As one interviewee said; ‘…he’s a self-funded retiree who’s paid $400,000 bond to be there and they give him two dead frankfurts and a blob of sauce or two party pies for dinner! It’s pathetic.’
“The facilities are required to have a dietician evaluate the nutritional content of food. The menu is sent to the dietician and the evaluation is done without the dietician seeing residents or the food served.”
The study also found relatives and carers were concerned the strong emphasis placed on preventing food borne pathogens leads to restrictions in the choice of food. Basic items such as lettuce and preserved meats were prohibited and some food such as tomatoes and apples were washed in diluted bleach.
“Yet we found family members had evidence of unhygienic kitchen and utensils and ground-in spilt food left on resident clothing,” Dr Bernoth said.
“The residents were left dirty and ate off utensils that would never be considered acceptable in their former homes.”
The report highlights problems some elderly residents experienced in accessing the food and water once it is served. This is a particular problem if there is no family member present to help the resident with tasks such as reaching a water bottle or removing the lid.
Dr Bernoth said, “In using the word ‘serendipity’ we hope to emphasis the accidental nature that our study found of the residents receiving adequate food and fluids in residential aged care.
“The inability of the aged care residents to receive proper nourishment and hydration obviously has adverse impacts on their health and is ultimately a violation of their human rights.
“The nutritional neglect remains a real and an ongoing issue of deep concern in Australian residential aged care.
“In this research, we are not looking to lay blame but to highlight real flaws in a system that is failing some of Australia’s most vulnerable people.”
The research was approved by the CSU Ethics Committee. When appropriate, research participants were referred to statutory authorities such as the Complaints Investigation Scheme.
“ ‘ Two dead frankfurts and a blob of sauce’ : The serendipity of receiving nutrition and hydration in Australian residential aged care” draws on a separate but related study, “ published in 2012.
Dr Bernoth made a submission in 2010 to the Productivity Commission Inquiry into Caring for Older Australians.